The invention concerns a hollow rasp for preparing a tubular bone for the insertion of a post-shaped endoprosthesis.
Before the implantation of a post-shaped endoprosthesis in a tubular bone, for example in the human femur, the bone is resected on the joint end, the spongiosa is routed and the bone marrow is removed. The post part of the endoprosthesis can then be placed in the routed space, where it is fixed with or without using cement. A typical example of this type of post-shaped endoprosthesis is a hip post in an artificial hip joint. Hollow rasps are known from the state of the art, for example, DE-U-9212906 and DE-A-4323873.
The hollow rasp in the last publication mentioned is different from the hollow rasp in the first publication mentioned basically in that its hollow tube has a medial longitudinal slit. This gives it better routing action than the rasp in the first publication mentioned. When used, it also substantially reduces the risk of thromboses and/or emboli, which go back to increased excretion of bone marrow fat, which can cause fat emboli in the patient.
The hollow-shaft rasp in the last publication mentioned is basically composed of spring steel with a scraper profile, which is designed so that it only works in one direction of movement of the rasp. During routing, excavated material is pushed inside the hollow tube.
In practice, it has been shown that the scraper profile used in the state of the art is not sharp enough to clear out the tubular bone quickly.
On this background, the problem of this invention is to propose a hollow rasp of the type mentioned at the beginning which has much greater rasping action than the hollow rasp in the state of the art.
The invention provides that the hollow rasp, to which a manipulating instrument can be coupled, be composed of a metal grid network, which is studded with metal rasp elements, at least at its junctions, which are an integral part of the material forming the grid network.
In particular, the hollow rasp in the invention is produced using a fine-casting wax melting method so that the rasp elements also remain bonded to the grid network even under high stress. The rasp elements work in all directions of movement.
Due to the rotationally symmetric design of the hollow rasp, it is also possible to set the hollow rasp with the manipulating instrument into a corresponding motor-driven machine and to use the hollow rasp as a motor-driven cutter. The rasp elements designed to be integral with the grid network definitely withstand these high stresses.
The bone marrow scraped off during the routing process and the scrapped off spongiosa are forced inside the grid network to prevent any risk of emboli or thromboses.
For continuous rasping or cutting, it is an advantage if a suction unit can be connected to the proximal side of the hollow rasp, and the cut or scraped off components can be suctioned off, as is known per se.
In one especially preferred form of embodiment, the rasp elements are composed of a basic body with at least three pegs projecting from it. This design gives a bone rasp aggressiveness unknown in the past.
In an advantageous variation, the hollow rasp in the invention basically has the outer contours of the endoprosthesis to be implanted. This is no problem because of a technically fine casting production process, unlike many state-of-the-art hollow rasps.
One special aspect is that the hollow rasp itself can remain as an implant in the routed bone marrow space. In other words, the hollow rasp can be used as such and then remain in the hollow space made by it. The aggressiveness of the surface and its hollow space allow bone material to organize relatively fast in the hollow space and grow around the rasp elements. One special advantage then is the possibility of uncoupling the manipulating instrument from the hollow rasp and, for example providing it with a joint ball by means of a double cone, whereupon the post part of an artificial hip joint is made from the hollow rasp.